Pregnancy Complications II
Quitting Your Bad Habits
Health And Nutrition
Working While Pregnant
Being A Stay-At-Home Mom
The Baby Shower
All About Feeding
Cord Blood Banking
Trouble Getting Pregnant?
Is It Safe?
Looking & Feeling Good
Naming Your Baby
Caring For Your Newborn
Baby Boot Camp
Sex & Pregnancy
Getting Good Sleep
Twins and Multiples
Breastfeeding: Tips, Hints And Advice To Make It Work For You
Our Experts In This Episode:
Dr. Bryan Vartabedian is an Assistant Professor of Pediatrics at Baylor College of Medicine and serves as an attending physician at Texas Children’s Hospital, America’s largest children’s hospital. He is also the author of Colic Solved: The Essential Guide to Infant Reflux and the Care of Your Crying, Difficult-to- Soothe Baby. Learn more at Dr. Vartabedian's website, ColicSolved.com.
Katy Lebbing is the manager of the Center for Breastfeeding Information at La Leche League International, the world's largest breastfeeding support group. Lebbing is also a La Leche League leader and an international board-certified lactation consultant.
Dr. Wanda Jones is the Deputy Assistant Secretary of Health, leading the Office on Women's Health, in the U.S. Department of Health and Human Services. The Office on Women's Health encourages breastfeeding, and has a wealth of information for you here.
Welcome to your Pea in the Podcast. I'm Bonnie Petrie with everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy.
This week, we'll talk about feeding your baby, nature’s way. We'll explore the very real benefits of breastfeeding...
"For every one breastfed baby that’s hospitalized, there are 10 formula babies that are hospitalized."
But while nursing is natural, that doesn't mean it is easy at first...
"He wouldn't latch on, he was really sleepy, which now I understand is quite typical. He had jaundice and low blood sugar."
But for many moms it is more than worth it...
"It's been one of the greatest experiences of my life."
We'll talk about nursing in public and we'll get you ready to go back to work...
"I tried to get a freezer stash going by pumping after each feeding."
We have a pediatrician, a lactation consultant and two moms who faced the challenges and have experienced the joy of nursing their babies. They'll help you decide if breastfeeding is for you in this Pea in the Podcast.
You wouldn't think it would be so difficult to decide how to feed your baby when there are just two options. But it is, and everyone has an opinion. Let's find out about what a pediatrician has to say...
"Well, obviously breastfeeding is going to have some real significant advantages for moms, or for babies rather. We have to keep in mind that breast milk is a living, breathing product that contains immunoglobulins and other things that help boost a baby's immune system and even boost their intelligence. So there are a lot of advantages that will come with breastfeeding that will last through a baby's first couple years of life. It's very, very important."
Dr. Bryan Vartabedian is a pediatrician at Baylor College of Medicine and the author of Colic Solved: The Essential Guide to Infant Reflux and the Care of your Crying, Difficult to Soothe Baby. He says if you can, give breastfeeding a try. It's human milk, which is the perfect food for a human baby. He already mentioned that studies do show that breastfed babies do have an advantage when it comes to brain development.
"They are not major differences, but they are statistically significant. One thing that we will definitely see is episodes of acute infectious diarrhea, viral diarrhea (are reduced). We tend to see fewer ear infections, as well, in babies who are breastfed and there are a lot more examples of ways that breast milk is advantageous, but those are some of the few things that we often see."
So those are some of the reasons to choose nursing. Lactation consultant and La Leche League Leader Katy Lebbing runs down her list of reasons for considering breastfeeding.
"A woman would want to choose nursing for many different reasons. One is it is just fun, whenever a woman nurses there are hormones that are released into her bloodstream that are very, very relaxing and it feels good to nurse. It's the natural continuation of the pregnancy. But looking at it from another angle, it is the healthiest choice. For every one breastfed baby that is hospitalized there are 10 formula babies that are hospitalized, except in the first four months it's one breastfed baby to 15 formula babies, so this isn't just a little bit healthier, this is a lot healthier. Breastfed children have significantly less illnesses, like I said, less hospitalizations and then there are also other things like higher IQ scores, less SIDS. And mothers have a lotf of advantages too. There are a lot of less cancers, less breast cancers, ovarian cancers, esophageal cancers, thyroid cancers and some other less osteoporosis in later life and things like that. So a lot of health benefits are because of breastfeeding, too."
Despite that, the decision to breastfeed remains difficult for some moms. Like Meghan, who thought for much of her pregnancy that she would formula feed.
"It was a pretty hard decision. Truthfully, the main thing that appealed to me about breastfeeding was the price. I really didn't think too much about the bonding aspect, in fact I wanted my husband to be able to feed the baby, too. Really, my mom had a pretty strong opinion that I should at least try breastfeeding, her basis being that she had done it with me and my two siblings, and after thinking about it I agreed to give it a try and figured if I didn't like it or if it was difficult I would just stop."
Lebbing says some are intimidated because those first couple of weeks can be really, really difficult.
"It's not instinctive; it's kind of a myth that all women know how to breastfeed, just like it’s a myth that because you are a man you know how to fix every car or to repair everything. You know, these are myths and that is why we named our book The Womanly Art of Breastfeeding, because it is just simply an art that one woman teaches another woman."
And in the beginning, it was difficult for Meghan.
"He wouldn't latch on, he was really sleepy, which now I understand is quite typical. He was a pretty small baby for full-term and his mouth was pretty small. He had jaundice and low blood sugar, and I think these might have all been challenges that we had to face while we were trying to get him started."
But once Meghan got started, she was determined to make it work.
"I got help from the lactation consultant at the hospital while I was there for my four-day luxury stay, and that was very helpful. They showed me how to stretch his mouth so that he would latch on better, they showed me how to use the pump (that was glamorous) and they just got us started. He wouldn't latch on at first so we wound up pumping and finger feeding him, and Brian, my husband, got to do that, too, so that was a really neat way for him to bond with the baby. And we just did the best we could. I also thought it was very painful at first, which really surprised me, and in fact I went home from the hospital bleeding in places that you wouldn't think you should bleed from. And that really surprised me as well."
So the learning curve can be sharp, and it can take several weeks for you and the baby to work it out.
"Probably a full month, we were getting better and then he had a backslide, for some reason, about the four-week mark, and I just worked through it and was very stubborn and supplemented with formula, and probably about the six-week mark everything was fine and back to normal."
And they never looked back. She and most nursing mothers who also bottle feed, which is called combination feeding, agree that once you get the hang of it, nursing is far easier than bottle feeding.
Sometimes the challenges faced by a new nursing mother come from circumstances beyond their control, and that was true for Amanda.
"I was able to nurse pretty quickly after an unplanned cesarean, so that was a good start. And I did nurse for a couple of days and then my daughter ended up with a minor fever, and at the hospital that I was at they don't have a sick child nursery, the baby goes straight to the NICU, the neonatal intensive care unit. So my baby was in that unit and I was separated from her, and I would go down and see her every couple of hours, as much as possible, but I was also recovering from surgery so I ended up pumping, I ended up offering milk through different means like supplemental nursing system or feeding with a syringe, and those are all helpful and have their place, but they were very difficult at that time. So that put a lot of challenges into our relationship in the first couple weeks. And I also ended up feeding her a few bottles of mother's milk and that made her prefer the bottle. So that could have been the end of our nursing at the breast right there. But luckily it wasn't."
Amanda was also determined to make nursing work despite the challenges.
"It felt like the last thing I could latch on to, so-to-speak, after having such a hard time with the end of my pregnancy and my daughter's birth. And I also think it just wasn't an option to go the other way. Once I found out that I had plentiful milk, I figured there had to be a way to get it in her that didn't involve a breast pump all the time, or bottles. So I figured I had the equipment, she was alright, we could work it out and I think once I submitted to the idea that it wasn't going to be perfect, it wasn't going to be peaceful and beautiful right away then that kind of relieved me of some of that pressure, and we were able to just work together and work through it."
Amanda also had a very tough recovery from her c-section. The incision didn't heal well. She credits nursing her daughter with helping her to keep her head above water emotionally.
"Well, I had a lot of trauma after my daughter's birth, and I had some post-surgical complications as well, and I was very happy to be nursing because I felt like it kept the connection between us at all times, and that doesn't mean I don't think I would have felt connected to her otherwise, but she literally needed me at that moment and I couldn't hand her off to anyone. And just having to be there for her, having to be ready for her, it kept me from kind of falling into despair. And I did have some postpartum depression, but I think that it was not as bad as it would have been if I had not been able to breastfeed directly or if I had been hooking up to the pump a dozen times a day right away. So I do think that it helped a lot because I just had to be there."
So what other challenges might you face and face down if you decide to breastfeed? Well, your nipples might hurt. Lactation Consultant and La Leche League Leader Katy Lebbing says that one is definitely dealable.
"Soreness is caused by incorrect positioning. It is just simply something that one woman would teach another how to properly hold the baby at the breast and how to put the breast into the baby's mouth properly and deep enough so that the baby's tongue isn’t t touching the tip of the nipple. When the baby is properly latched onto the breast, the nipple is very far back in the mouth and soreness would not be possible with that type of a latch."
Not everyone deals with nipple pain. I didn't. Amanda didn't.
"I was happy not to experience too many problems in that regard, and I think the reason is, my friend, a La Leche League veteran, suggested that keeping the breast clean and dry and not wearing a bra all the time, that really helps a lot. Many women will wear a firm bra and then put pads in it and they don't necessarily change the pads that often because they don't feel wet, but all that time there is bacteria and yeast just having a party on the breast, and that leads to problems like thrush or can lead to infection or just the cracking and pain."
You also might worry that you won't be able to provide enough food for your baby. Many new moms convince themselves they’re starving their child when they are not. Almost everyone can produce enough milk for their baby if they nurse enough.
"The most common reason for not enough milk is not knowing how the milk is produced and how to make enough milk. The more the breasts are stimulated, the more milk there will be. So by nursing very frequently, at least every 2-3 hours, the breast should make more than enough milk and there shouldn't be a problem. Also, some women introduce an artificial nipple too soon, like a pacifier or a bottle nipple. Even if it is a bottle of expressed breast milk, in those early weeks, those first 3-4 weeks, most babies can't go back and forth between the artificial nipple and the human nipple and so we caution women about introducing an artificial nipple too soon, so that babies have a few weeks of really good nursing before they have to start doing something different with their tongue, and by nursing very frequently, again, mothers will have plenty of milk."
Sometimes doctors and nurses interfere with a new mom's best efforts to nurse. For example, if your baby is jaundiced, you may be pushed to give them a bottle, or more than one. That may not be the best course of action.
"We know that jaundice -- good point -- the more the baby breastfeeds, the more milk we can get into the baby, the faster we can get that jaundice to leave. It leaves through the stool, and so by being prepared, by having people that she knows that she can talk with right away if she's having a difficulty immediately, as soon as she is having a difficulty, if she knows that her doctor is very knowledgeable about breastfeeding, then she is fine, but if there is not a doctor like that, she may need to call others that can help her, who can help her, then give the doctor research from the professional literature to help her through that stage."
So it really is a good idea to read a breastfeeding book or two when you're pregnant, or maybe take La Leche League's crash course in breastfeeding, so you can be prepared for things like this. But from mom Amanda's perspective, unrealistic expectations may be the greatest challenge a new mom faces.
"You can read a book and it might say that a baby nurses every two to three hours, so if your baby wants to nurse every hour, you might assume you don't have enough milk or that something is wrong with your milk. These are problems I see a lot with new mothers, and I even experienced them, too. I read all of the same books, but the book doesn't translate in those early days."
And in those early days, don't be surprised if your baby nurses all the time.
"Pretty much all babies go through stages where they nurse more than they do anything else."
It's how they build your milk supply, and their tummies are tiny, too. It doesn't take much to fill them, and they empty quickly, so they need to eat often. I promise, the frequent nursing doesn't last forever and when your baby is older, believe it or not, you're going to miss that time alone, in the night, together, that you had with your baby.
The most important thing that you need to do if you plan to nurse is build a support network.
"Talk to any friends who have nursed before, and not necessarily just the ones who had great success, talk to the ones who didn't and see what you can hear in their stories."
Amanda had great luck with her local La Leche League.
"To be honest, I was a little turned off based on things I had heard from other people, but after I had been breastfeeding for awhile, I decided I was going to take the plunge and go, and I loved it and I always want to tell new mothers don't be afraid, don't stay away based on something you’ve heard from a friend or a friend of a friend, that it's something that you should go check out, and every group has a different flavor so if you don't click with the first group, it doesn't necessarily mean La Leche League is not helpful for you."
La Leche League Leader and Lactation Consultant Katy Lebbing says there’s plenty of support at that organization.
"Each group meets once a month for pregnant women to learn about breastfeeding and then to support the nursing mother and her baby after birth. La Leche League Leaders not only do those monthly meetings, but they also, since the meetings are only once a month, most of the work that they do is supporting the breastfeeding mothers throughout the month, helping with phone calls and emails."
Or you can hire a Doula or a Lactation Consultant. It's good to have them available to you when you are in the hospital. Make sure you have their numbers handy.
One final thing that intimidates new mothers is nursing in public, and it can take some getting used to. But mom Amanda says you can do it, and you can do it discreetly.
"I actually wear pretty modest clothes, probably overly modest by some people's opinion, but I don't hesitate to nurse in public because it's not about my breasts, it's about my daughter needing to eat."
It does take some practice to figure out what works for you and your baby.
"The first time I nursed my daughter in public, we were in an extremely crowded waiting room waiting for our oil to get changed, and I was wearing a heavy poncho over my outer garments and so I ended up nursing her under this heavy poncho and it was so hot for both of us and her head, I brought her out and her hair was all sweaty and I just felt so grossed out by it. So I decided that I wasn't going to do it that way anymore. So what I learned to do was to just cover my breast while not covering her head and then we were both happier."
Some moms use blankets, some moms nurse in slings, for me the secret was good nursing shirts and bras. I'm well endowed and if you think anyone was going to have a problem nursing in public it would be someone like me. But my baby and I became so good at it we nursed everywhere, at the store, in restaurants, even at a professional baseball stadium and no one ever got a hint of boob. Well, maybe just a hint, but that's all. Legally, most states say you can nurse your baby anywhere you have the right to be. So don't feel as though you have to nurse in the bathroom. Who wants to eat in the bathroom? I'm sure your baby doesn't. You don't have to nurse isolated in your car either. Just practice until you and your baby feel comfortable and go for it.
Most moms who plan to return to work will be bottle-feeding some of the time and nursing moms will have special concerns there. You'll need to pump at work and that may take some fancy footwork. Mom Meghan got started early trying to fill her freezer with expressed breast milk.
"I tried to get a freezer stash going by pumping after each feeding, which was actually very difficult, and I tried to practice with a pump, and the week before I went to work I actually had Alex start two days at preschool early and just practiced pumping at times when I would normally be feeding to see how my body responded to the pump, and the new routine and that actually went a lot better than I thought and just took the time when he was at preschool to relax a little and try and get my bearings for what was ahead."
When you get to work, you may find your boss isn't prepared to allow you to take breaks to pump, and they may not have anyplace set aside where you can do it privately. Dr. Wanda Jones of the US Department of Health and Human Services says, well, they really don't have to.
"Many states have no workplace-relevant legislation. There is no national legislation that provides a basic level of fundamental right. So, you know, it is very much an employer/employee relationship that has to be entertained to facilitate pumping and lactation support in the workplace."
But Dr. Jones says employers should see the benefit to the bottom line of allowing their employees to pump three times a day.
"The businesses, the employers, should recognize the direct benefits when the infant is less likely to be sick due to an ear infection, a respiratory illness or diarrhea because it is being breastfed exclusively, mom is going to miss a lot less work. When daycare requires that infants be fever free for 24 hours, it might actually mean that mom has to miss two days of work, caring for an infant who has been sick. So when employers can recognize that there is a direct benefit here, it also increases loyalty, female employees who are supported actually report a much more positive attitude toward their employer and it does cost an employer money to lose employees and have to hire and train new ones."
Mom Meghan said she had break some new ground to get the kind of support she needed in the workplace.
"Although I had some challenges getting people I work with to understand why it wasn't really appropriate to pump in the bathroom, eventually they either got it or they humored me and that worked out, and, in fact, although I was the first woman ever to pump on the job, a couple women at the first company I worked for when I returned from leave are now pumping for their new babies, so I'm proud of that, too."
So how do you approach your boss? Dr. Jones at the US Department of Health and Human Services has a couple of ideas.
"Well, it is difficult, and I think (it's important) for new moms, or particularly for women who are pregnant who are considering breastfeeding, to find out how other women have navigated the conversation with their employers. It might be possible to call upon the La Leche League Chapter or another breastfeeding support group locally that you can talk to women about how they have made this work for them, what they have presented to their employer, how they have adapted."
It's best to talk to your boss about this now while you're still pregnant and not your first day back from maternity leave, and Meghan says go in with confidence.
"Don't give up, know your rights. If you don't have any rights, push for them anyway and pretend that it’s your right."
Some moms are surprised that they at first have trouble getting a lot of milk when they pump.
"I wouldn't have expected that either, but it's not a natural contraption and it just kind of takes some getting used to."
Yeah, you sort of have to train your breasts to produce for the pump, it's not the same as a baby and lactation consultant and La Leche League Leader Katy Lebbing says it's totally normal not to get much.
"The pump does not pull out as much as the baby. There are some exceptions to that; there are some hospital grade pumps. There are some mothers who choose to exclusively pump and there are pumps that we can guide them to for that as well."
If you find you can't keep up with your baby's needs, there is always combination feeding. A lot of moms do this and Meghan did.
"Well, I just wasn't able to pump enough at work to be able to meet his needs and so he would get as much mother's milk as he could during the day, and anything that he still needed we would just make up the difference with formula, once the freezer stash was exhausted, and I wish he hadn't had to have so much formula, but it can't be helped and I'm not going to beat myself up over it."
You only have to pump several times a day for a couple of months and then you ease back to two times a day and then once, and then you could eventually put the pump away.
Ultimately for many moms, nursing becomes more than just a way to feed your baby.
"It's been one of the greatest experiences of my life and most of the time it's just a quiet and sweet thing and it's just utter simplicity and just such an easy connection, I just am very grateful for it."
Even if you have supply problems, like I did because I've had a breast reduction, or for some other reason, you can still give your baby a significant amount of mother's milk and every little bit is a gift to your baby.
So consider it, it's an amazing way to bond with your little one and give them a great start in life.
We hope you've enjoyed this Pea in the Podcast: Breastfeeding. Please visit our website, PeaInThePodcast.com for more information about our experts, to find links and transcripts and to register to get tailored week-by-week shows for each week and stage of your pregnancy. It's everything you need to know about your body, your baby, and the big changes ahead in your life in your journey to becoming a mommy. For Pea in the Podcast, I'm Bonnie Petrie, thanks for listening.
A Special Thanks To...
Meghan in Missouri and Amanda in Minnesota for sharing with us their stories of breastfeeding their babies.